DIABETES DISTRESS LEVEL HIGH AMONG YOUNG PEOPLE, DUBAI RESEARCH FINDS
▶ One in three suffer from the condition, which is characterised by anxiety, depression and fear of complications
Young people with Type 1 diabetes should be routinely screened for mental health issues, researchers said, after a study found that almost a third of them suffer from severe distress because of their condition.
Maintaining blood glucose levels within targets and having regular doses of insulin, among other things, put adolescents with Type 1 diabetes under constant tension, according to the research.
Early referral may prevent distress and depression from becoming worse, although cultural factors make some patients and their parents resistant to the idea of a mental health assessment.
The experts behind the study, based at Dubai Diabetes Centre, found higher-than-expected levels of depression and diabetes distress, a term that refers to the fear of complications, of low blood-sugar levels, among other pressures, caused by the disease in Type 1 diabetic adolescents.
“I was very surprised to see almost one third had such a high score,” said Zeina Younes, study author and a dietitian at the centre who consults with patients daily.
There are thought to be about 149,000 young people with diabetes in the Middle East and North Africa, so issues affecting their mental health are treated as highly significant.
“Diabetes management requires strict daily regimens of frequent blood glucose monitoring, food intake and insulin dosing, placing adolescents under constant tension,” the study said. Published in Paediatric Diabetes, the research analysed 72 people, aged between 13 and 18 with Type 1 diabetes who attended the clinic.
They were assessed by the Problem Areas in Diabetes (Paid) questionnaire, an international model of assessment based on questionnaires in which respondents rate the seriousness of their problems.
About 31 per cent of those assessed had “severe diabetes distress”, and diabetes distress and depression were highly correlated.
Severe diabetes distress was twice as prevalent among girls, affecting about 42 per cent, and Ms Younes said this could be because of biological, psychological or cultural factors, including a greater readiness to describe their feelings.
“With females, they tend to be more likely to express how they feel. So we still need more research to see why females have more distress,” she said.
Another finding was that young people who used insulin pumps were significantly less likely to suffer diabetes distress than those on daily injections.
“We think it could be related to the stigma of injections,” Ms Younes said.
“We hypothesised that it could be related to using needles in public or having to justify the use of needles. This could cause a lot of the increased stress they feel.”
Ms Younes and her colleagues sometimes faced resistance among patients and their parents to the idea of being seen by a mental health professional.
“It’s important we have the patients on board and that they understand the significance,” she said.
Ms Younes said it could be difficult to get patients and their parents to see a referral as helpful but when parents understood how distressed their child was, they became more willing for an appointment to be made.
Mental health issues can affect a patient’s condition because other studies have shown that higher levels of depression are linked to poorer monitoring of blood glucose levels as well as lower quality of life.
“It’s very important the patients have a routine psychological screening,” said Ms Younes. “We recommend routine screening and to start intervention as early on as possible.”
Treatments such as cognitive behavioural therapy, an intervention that aims to combat negative thought patterns, may help.
In adults with diabetes, cognitive behavioural therapy has been shown to reduce depression and improve glycaemic control, Ms Younes said, so it may prove helpful with younger people, too.